Active NPI
Lynnore Frances Pantaleon Burnham
- Physical Therapy Assistant
- Ewa Beach, HI
National Provider Identifier
1629564273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA-401
- Practice address
- 91-1384 Halili St
Ewa Beach, HI 96706-6538 - Phone
- (785) 550-3782
- NPI assigned
- Jul 6, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA-401 | HI | Primary |
Addresses
Primary practice location
91-1384 Halili St
Ewa Beach, HI 96706-6538
Mailing address
PO Box 60348
Ewa Beach, HI 96706-7348
Phone (785) 550-3782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-401 | HI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1629564273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60348",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967067348",
"telephone_number": "785-550-3782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-1384 HALILI ST",
"city": "EWA BEACH",
"state": "HI",
"postal_code": "967066538",
"telephone_number": "785-550-3782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNHAM",
"first_name": "LYNNORE FRANCES",
"middle_name": "PANTALEON",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-06",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "HI",
"license": "PTA-401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ewa Beach, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.